Impact of scalpel type on operative time and acute complications in thyroidectomies

INTRODUCTION: Thyroidectomy is the most common surgery in the cervical region. Currently, several techniques are available for intraoperative hemostasis. OBJECTIVE: To compare the performance of three techniques (monopolar and bipolar electrical and ultrasonic) on operative time and postoperative complications. METHODS: Patients submitted to total thyroidectomy without prior treatment were included in this prospective series study, using a scientific design. RESULTS: A total of 834 patients were included; 661 women (79.3%) and 173 men (20.7%). The diagnosis was malignant neoplasia in 528 patients (63.3%) and benign disease in 306 patients (36.7%). The monopolar electric scalpel was used in 280 patients (33.6%), bipolar scalpel in 210 patients (25.2%) and ultrasonic scalpel in 344 patients (41.3%). The operative time was significantly shorter with the ultrasonic or bipolar scalpel when compared to the electric scalpel. In a linear regression model, gender, malignancy diagnosis and power energy type were significant for the procedure duration. Patients who underwent surgery with an ultrasound or bipolar scalpel had a significantly lower incidence of hypoparathyroidism. CONCLUSION: The use of ultrasonic or bipolar scalpel significantly reduces operative time and the incidence of transient hypoparathyroidism.